Diabetes Forecast

Skier Kris Freeman's Vancouver 2010 Olympics Performance

By Tracey Neithercott ,

Let's get one thing straight: Kris Freeman is thought to be the first athlete with diabetes to compete in an endurance sport on the Olympic stage. Last month, he was America's best hope for gold in cross-country skiing. So despite an episode of low blood glucose and two lackluster performances that forced the 29-year-old to leave Vancouver without a medal, Freeman is still covering new ground-and he says he's not giving up.

Diabetes Forecast caught up with Freeman post-Olympics to discuss how his type 1 diabetes played a role in his performance-and to find out what he has planned for the 2014 games. (Click here to read our pre-Olympics interview with Freeman.)

Tell me about your experience in Vancouver.

I had a pretty disappointing Olympics, results-wise. In the 15-kilometer, I had pretty good blood sugar control, but before the race they closed the course until 15 minutes before. I couldn't test my skis. I ended up with poor skis in that event. In the 30-kilometer, I had a blood sugar low that forced me to stop to get more sugar in my system. So that was not great. Overall, it was the worst race I've had in my career.

When they closed the course for the 15K, did you feel forced to choose between testing your blood glucose and testing your skis?

I probably could have tested my skis and my blood sugar at the same time, but I generally like to test my blood sugar in a warm environment, not in front of a lot of people and all of the excitement. I like to go into my own wax room and be alone.

You started feeling weak and knew you had low blood glucose during the 30K event. Why do you think you had such a bad hypoglycemic reaction this time compared with your past events?

At the start, I felt very relaxed, very in control. It was then [that] I had the hypoglycemia. The crowd gave a bottle of Powerade and goo gel. It's the Olympics, and I was still in racing mode and I didn't want to drop out of the race. I've had trouble all year. I've been playing catch-up trying to figure out my doses. I haven't used the OmniPod [insulin pump] for [races that were so] long. I didn't figure out a good dosing plan for the 30-kilometer.

People might think your fix would be to race with really high blood glucose. But what problems do you encounter when you go too high instead?

If you allow [your blood glucose] to go high, your performance will suffer. There's a correlation with high blood glucose and excess lactate production. I've seen a correlation with artificial lactate production, and when I go over 200 [mg/dl], I'm concerned with my performance. But you can't go low. It's a pretty tight window to play, and when it's a tight window you mess up. And unfortunately it was at the Olympics this time.

After finishing the 30K despite going low during the race, you were only able to complete 20 kilometers of the 50K race. Was that related to your diabetes?

I was completely out of glycogen [which your muscles tap for fuel during endurance events]. After I did the 30K, I got a cold about 36 hours later. Between the cold and the severe glycogen depletion I had going into the 50K, my coaches said, "If things aren't going well, we're going to pull you." It wasn't my decision.

You have had to do all your own research regarding how to manage diabetes at an Olympic level. Did the 2010 winter games teach you anything new about how your basal rates, your mood, the weather, and other factors affect your diabetes in competition?

There's more stress than at any event. I thought I was pretty relaxed, but I could have done a better job. Once things were going badly, I let them cascade. This disease, you can always know more. You can always take better care of yourself.

Do you think that advances in diabetes technology will help you compete at the highest level?

I have more interest in the continuous glucose monitors [CGMs] now. I got hooked up with a DexCom unit that I'm learning. I hope I can use that in upcoming races. They hadn't been around that long. Reliability came into play, but I'm ready to use one now.

You wear an OmniPod insulin pump underneath your uniform. Is finding a spot to hold the CGM receiver tricky, considering your sport?

I'm not sure how it would go. It might include duct tape.

What was the Olympic experience like? How did this year's Olympics vary from the other two—Salt Lake City in 2002 and Torino, Italy, in 2006—you've competed in?

It's always cool to be around the best athletes in the world, and the general excitement is a great feeling. Canada did a great job hosting it. It was the most comfortable Olympics I've been to.

What are your future plans, particularly for the 2014 Olympics in Sochi, Russia?

I have the 50K U.S. National Championship coming up [at the end of March]. Over the next couple weeks I'll be trying to unwind and get my fitness and health to where I can go out and have a great performance at Nationals. I plan to race for the next four years.

Along with training for competition, you spent some time last year with Eli Lilly visiting diabetes camps. Do you plan to do more things like that this year?

I'm looking forward to spring and summer. I'm traveling with Eli Lilly to diabetes camps and talking to kids about diabetes. I wish I could tell them I won a medal, but it's a learning example. What I say at the camps is: "You shouldn't get upset if you mess up with your blood sugar. You should move on. I'm still learning."

Just as you were, many kids are told that they can't compete in an endurance sport because of their diabetes. What would you tell kids who think diabetes will hold them back?

I would get away from the person who told them they can't—and do something. It's a major inconvenience and a pain in the butt, but I'd like to see them do what I'm doing. Or even do it better than me, and I can follow them.



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